Who should consider having surgery for dystonia?

Patients should consider deep brain stimulation if they meet the following criteria:

- Diagnosis of primary dystonia, diagnosed by a movement disorder specialist, and after secondary causes of dystonia have been ruled out.

- The dystonia is severe enough to adversely affect quality of life by interfering significantly with normal activities or causing social isolation.

- Adequate medication trials have been unsuccessful including carbidopa/levodopa (Sinemet) and anticholinergic medications such as trihexyphenidyl (Artane) or benztropin (Cogentin). Baclofen and muscle relaxants such as clonazepam also tried prior to consideration for surgery.

- Dystonia affects too large a body area to be treated effectively with botulinum toxin injections (Botox), or prior attempts at injections with botulinum toxin have been unsuccessful.

- The patient and family understand the nature and complexity of deep brain stimulation (DBS) therapy including that the treatment is too novel to guarantee successful treatment in any individual case.